Provider Demographics
NPI:1407087901
Name:TAMPA REHAB & CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:TAMPA REHAB & CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-507-4441
Mailing Address - Street 1:8710 W HILLSBOROUGH AVE
Mailing Address - Street 2:SUITE 323
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3705
Mailing Address - Country:US
Mailing Address - Phone:813-888-5102
Mailing Address - Fax:813-888-5121
Practice Address - Street 1:5511 HANLEY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4903
Practice Address - Country:US
Practice Address - Phone:813-888-5102
Practice Address - Fax:813-888-5121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty